The story of HIV in America is the story of HIV among black Americans, who are over eight times more likely than white Americans to test positive for the virus.

In the next few days, we’ll take a trip to Atlanta, the black gay mecca, to unravel the mystery of what is driving these high HIV rates in the black community.

What has never been a mystery, though, is the magnitude of the problem:

Black Americans make up a bigger share of people living with HIV than any other ethnic group. That gap will only continue to widen because black Americans also have the highest rates of new HIV diagnoses. Nearly half of all new cases of HIV are among black Americans.


It’s important to remember that black (non-Latino) Americans are just 12 percent of the population. But the virus is so concentrated in the black community that black Americans account for a huge share of the HIV-positive.


How did it get to be this way? Since the beginning of the epidemic, black Americans have always been disproportionately affected by HIV. The introduction of drugs that could combat the virus added a new dimension, sharpening the differences between those who did or did not have access to healthcare.

Overall, the rate of new infections has been going down for all ethnicities. Fewer and fewer people are getting infected with HIV each year, though the gap between black and white Americans has not shrunk much. In 2002, black Americans were 10 times more likely to become infected with HIV than white Americans. By 2011, that number was still somewhere between 8-9 times more likely.

The other way to look at the HIV epidemic is to consider how people get infected. Broken out this way, the data show that for a decade now no progress has been made among gay men.

So perhaps the best way to understand the persistent epidemic among black Americans is to look at black men who have sex with men.

What’s driving HIV rates among this community? The most obvious explanation, that black men are having more sexual partners or more unprotected sex, has been shown to be false time and time again. If it’s not behavior that’s causing these disparities, what is it?